Outcome of patients with haemodynamically stable ventricular tachycardia treated with an implantable cardioverter-defibrillator.
BACKGROUND
The benefit of implantable cardioverter defibrillator (ICD) therapy in patients with haemodynamically stable ventricular tachycardia (VT) is not well documented.


METHODS
In this single-centre observational study, we examined the medical records of 53 patients (48 men, mean age 66 +/- 1 years) treated with an ICD. The patients were classified into four groups with comparable clinical and electrophysiological characteristics, as follows: patients presenting with (a) stable VT, (b) unstable VT, (c) cardiac arrest, and (d) non-sustained VT and induced sustained VT or ventricular fibrillation (VF) on electrophysiological study. Kaplan-Meier event-free survival curves were constructed and the incidence of appropriate device therapy was compared among the four groups.


RESULTS
All patients had structural heart disease with a mean ejection fraction of 32.5 +/- 1.3%. During a mean follow-up period of 35.5 +/- 2.7 months, event-free survival was similar in the four groups. However, appropriate device therapy occurred in 9 (81.8%) patients with stable VT, in 6 (44.4%) patients with unstable VT, in 2 (33.3%) patients with cardiac arrest and in 6 (33.3%) patients with non-sustained VT and induced sustained VT/VF. Compared to the total patient cohort, appropriate therapy was significantly (p = 0.024) more common in patients presenting with stable monomorphic VT. In 2 (22.2%) of these patients, the tachycardia rate was faster than the presenting VT.


CONCLUSIONS
High recurrence rates are observed in patients with structural heart disease and stable VT, with a considerable proportion being faster than the presenting VT. ICD therapy is beneficial and should be offered in these patients.
Kolettis
Theofilos M
TM
Department of Cardiology, University of Ioannina, Greece. thkolet@cc.uoi.gr
Krikos
Vassilis D
VD
Apostolidis
Dimitris
D
Naka
Katerina K
KK
Katsouras
Christos S
CS
Sourla
Eleni
E
Michalis
Lampros K
LK
D000368:Aged; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use; D017147:Defibrillators, Implantable; D018572:Disease-Free Survival; D022062:Electrophysiologic Techniques, Cardiac; D005260:Female; D006439:Hemodynamics; D006801:Humans; D008297:Male; D011379:Prognosis; D016016:Proportional Hazards Models; D012008:Recurrence; D017180:Tachycardia, Ventricular / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D016896:Treatment Outcome
D000889:Anti-Arrhythmia Agents